What are the recommended preventative health STD screenings?

Recommended Preventative Health STD Screenings

All sexually active women under 25 years of age should be screened annually for chlamydia and gonorrhea, while those with high-risk behaviors should also be screened for HIV and syphilis regardless of age. 1, 2

Population-Specific Screening Recommendations

Women

• All sexually active women younger than 25 years should receive annual screening for chlamydia and gonorrhea 1, 2
• Women 25 years and older with high-risk sexual behaviors should be screened for chlamydia, gonorrhea, HIV, and syphilis 1
• High-risk behaviors include: multiple current partners, new partners, inconsistent condom use, sex under the influence of alcohol/drugs, exchanging sex for money/drugs 1
• Women diagnosed with chlamydia or gonorrhea should be retested approximately 3 months after treatment 1, 2

Men

• Sexually active men at increased risk should be screened for HIV and syphilis 1, 2
• Men who have sex with men (MSM) should be screened for:
  • Chlamydia and gonorrhea at exposed anatomical sites (pharynx, urethra, rectum) 1
  • More frequent screening (every 3-6 months) for MSM with multiple/anonymous partners, those who use drugs during sex, or have partners who do 1
• The USPSTF concludes evidence is insufficient to recommend routine screening for chlamydia and gonorrhea in men who do not have sex with men 3

Pregnant Women

• All pregnant women should be screened for hepatitis B, HIV, and syphilis at the first prenatal visit 1, 2
• Pregnant women at increased risk should also be screened for chlamydia and gonorrhea 1, 2
• High-risk pregnant women should have repeat syphilis testing in the third trimester and at delivery 2
• Pregnant women diagnosed with chlamydia in the first trimester should be retested during the third trimester 1

Special Populations

• Persons entering correctional facilities should be screened for syphilis, gonorrhea, and chlamydia 1, 2
• Adolescents in institutional settings should be screened for gonorrhea and chlamydia 1, 2
• All persons who use drugs illicitly should be offered screening for hepatitis C virus (HCV) infection 1
• Persons with HIV should be routinely screened for STDs including gonorrhea, chlamydia, syphilis, and (in women) trichomoniasis 1

Screening Frequency

• For most populations at risk, screening should occur at least annually 1
• More frequent screening (every 3-6 months) is recommended for individuals with ongoing high-risk behaviors or in communities with high STD prevalence 1
• Persons diagnosed with an STD should be rescreened approximately 3 months after treatment 1, 2

Common Pitfalls to Avoid

• Failing to screen extragenital sites (pharynx, rectum) in MSM, which can miss a significant number of infections 4, 5
• Not rescreening patients after treatment for chlamydia or gonorrhea 2
• Overlooking screening in pregnant women, especially repeat testing for high-risk women 2
• Focusing only on genital testing when patients may have infections at other anatomical sites 4
• Neglecting to screen young women under 25 years, who have higher infection rates due to cervical ectopy and immune system factors 1

Partner Management

• Sex partners of persons with STIs should be evaluated and treated 2
• Partner notification can be performed by the patient, healthcare provider, or public health officials 2
• Consider presumptive treatment for partners of persons with curable STIs 2

By clustering STI screening at periodic health examinations, providers can efficiently implement these recommendations and improve detection rates 1, 2.